Manaseer Thaer S, Gross Douglas P, Mrazik Martin, Schneider Kathryn, Whittaker Jackie L
Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada.
Department of Sport Rehabilitation, Faculty of Physical Education and Sport Sciences, Hashemite University, Al Zarqa'a, Jordan.
Physiother Theory Pract. 2021 Jul;37(7):763-774. doi: 10.1080/09593985.2019.1648624. Epub 2019 Aug 1.
While postural control impairment is common following sport-related concussion, few investigations have studied the physiological basis for this impairment. Both the Reflex/Hierarchical Model and the Systems Model are commonly used to characterize the physiological basis of postural control. To discuss the physiological basis of postural control impairment resulting from sport-related concussion based on these models and suggest directions for future research. Narrative literature review. Postural control impairment seen with sport-related concussion is a multifaceted construct that can result from deficits in numerous systems that underlie postural control as described by the Systems Model, rather than a unidimensional construct that stems from the central nervous systems' inability to integrate sensory input to control posture as per the Reflex/Hierarchical Model. We recommend a transition away from the Hierarchical/Reflex Model of postural control towards the Systems Model in the conceptualization of sport-related concussion. Future research on postural control following sport-related concussion should account for the multifaceted nature of the resulting postural control impairment based on the Systems Model. Clinically, there is a need for a clinical postural control test that allows examination across the affected systems under single-task, dual-task, and sport-specific paradigms.
虽然姿势控制受损在与运动相关的脑震荡后很常见，但很少有研究探讨这种损伤的生理基础。反射/层次模型和系统模型都常用于描述姿势控制的生理基础。基于这些模型讨论与运动相关的脑震荡导致的姿势控制损伤的生理基础，并为未来研究提出方向。叙述性文献综述。与运动相关的脑震荡所见的姿势控制损伤是一个多方面的结构，可能是由系统模型所描述的姿势控制基础的众多系统中的缺陷导致的，而不是像反射/层次模型所描述的那样，是源于中枢神经系统无法整合感觉输入以控制姿势的一维结构。我们建议在运动相关脑震荡的概念化中，从姿势控制的层次/反射模型转向系统模型。未来关于运动相关脑震荡后姿势控制的研究应基于系统模型考虑由此产生的姿势控制损伤的多方面性质。临床上，需要一种临床姿势控制测试，能够在单任务、双任务和特定运动范式下对受影响的系统进行检查。
